After resident’s death, Iowa nursing home is being fined $2,200 per day

In the wake of a resident death caused by an untreated bed sore, an Iowa nursing home is continuing to accrue daily fines for failing to comply with federal regulations.

So far, those fines total more than $139,707, with an additional $2,200 in fines added each day the home remains out of compliance, according to state and federal regulators.

State inspection records show that in January, the staff at Sanford Senior Care in Sheldon, a 70-bed nursing home affiliated with the Sanford Medical Center, found that a male resident of the home had developed a reddened area on his coccyx, or tailbone. The staff failed to assess and treat the situation or notify the man’s family or physician — even after it developed into an open sore in February, according to inspectors.

The resident died on March 6. According to state inspectors, the immediate cause of death was MRSA cellulitis — a dangerous skin infection that stems from staph bacteria — caused by the open wound.

“There was bloody skin on both sides of the buttocks and continuing down it looked like hamburger,” a nurse aide reportedly told inspectors. The facility’s director of nursing allegedly informed inspectors that certain employees were disciplined as a result of the death, adding, “We are trying to do everything possible to prevent this from occurring again.”

Administrator Richard Nordahl referred all questions on the matter to Sanford Health, which then issued a written statement, attributed to Nordahl, that said, “Due to privacy laws, we are unable to provide any comment on this inquiry.”

No state fines were imposed as a result of the death, although the Iowa Department of Inspections, Appeals and Licensing’s website indicated a federal fine of some sort was imposed by the Centers for Medicare and Medicaid Services.

When asked, DIAL initially declined to disclose any information about the fine and referred the Iowa Capital Dispatch to CMS. A CMS spokesman then referred the Capital Dispatch back to DIAL. On Tuesday, a DIAL spokesman said the state agency had conferred with CMS and had obtained the federal agency’s “permission” to release the information.

DIAL now says that after it was determined that regulatory violations had placed residents of the home in immediate jeopardy, a fine of $12,130 per day was imposed for the six days the jeopardy existed. The penalty totaled $72,780, but was reduced 35% by CMS, to $47,307, presumably because the home didn’t appeal the fine.

After the immediate-jeopardy situation was resolved, other issues still remained and so the daily fines continued but at the rate of $2,220 per day beginning March 12, 2025, according to DIAL. That particular fine will continue to accrue, DIAL says, until the facility “has made the necessary corrections to achieve substantial compliance” with regulations.

As of Tuesday, April 22, that $2,200 daily fine would have totaled $92,400. Combined, the two federal fines totaled $139,707 as of that date — although the second set of daily fines, like the first, remains subject to a 35% reduction if the home chooses to forgo an appeal.

On CMS’ five-star quality scale, the Sheldon facility currently has a one-star overall rating — the lowest possible score.